Stevia leaf extracts have been used for many years in traditional treatment of diabetes in South America. Paraguay's rural and native populations have used stevia for birth control.

Stevia contains compounds called rebaudioside A (Reb-A) and stevioside. These are used as natural sweeteners or dietary supplements. They reportedly possess up to 250 times the sweetness intensity of sucrose. Reb-A has been given Generally Recognized As Safe (GRAS) status by the U.S. Food and Drug Administration (FDA) and is used in some beverages as a zero-calorie sweetener.

Available research is promising for use of stevia in high blood pressure and type 2 diabetes, although more well-designed studies are needed.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Some evidence suggests that stevia may have blood pressure-lowering effects. However, there are conflicting results. More research is needed to compare the effectiveness of stevia to the current standard of care.

C

Limited evidence suggests that stevia may lower blood sugar in people with high blood sugar. However, further research is needed before a firm conclusion can be made.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

For high blood pressure, 250-500 milligram capsules of stevioside or stevioside powder have been taken by mouth three times daily for three months up to two years. Up to 15 milligrams per kilogram of crude steviosides have been taken by mouth twice daily for 24 months.

For high blood sugar, one gram of stevioside has been taken by mouth with a single meal. Five grams of water-based stevia leaf extracts have been taken by mouth every six hours for three days.

Children (under 18 years old)

There is no proven safe or effective dose for stevia in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in people with a known allergy or sensitivity to stevia or to members of the daisy family (Asteraceae/Compositae). Other members of the daisy family include ragweed, chrysanthemums, marigolds, and many other herbs.

Side Effects and Warnings

Stevia is likely safe when 250-500 milligrams are taken by mouth three times daily for up to two years in Chinese adults with high blood pressure. This dose range is possibly safe in non-Chinese adults with high blood pressure.

Stevia may cause low blood pressure. Caution is advised in people taking agents, herbs or supplements that lower blood pressure.

Stevia may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking agents, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Use cautiously in people with kidney disease or dysfunction or those with low blood calcium.

Use cautiously in people who are taking agents that affect blood vessel width, including calcium channel blockers.

Use cautiously in children and in pregnant or breastfeeding women.

Use cautiously if using stevia for longer than two years.

Avoid in people with a known allergy or sensitivity to stevia or to members of the daisy family (Asteraceae/Compositae).

Pregnancy and Breastfeeding

There is a lack of scientific evidence on the use of stevia during pregnancy or breastfeeding.

Stevia may cause low blood pressure. Caution is advised in people taking agents that lower blood pressure, including vasodilators such as calcium channel blockers.

Stevia may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or agents for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Stevia may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

Stevia may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Stevia may also interact with anticancer herbs and supplements, antifungal herbs and supplements, anti-inflammatory herbs and supplements, antimicrobials, antioxidants, antiviral herbs and supplements, catechin, cholesterol-lowering herbs and supplements, herbs and supplements for appetite suppression, herbs and supplements that affect blood vessel width, herbs and supplements that increase urination, herbs and supplements used for fertility, herbs and supplements used for the heart, hormonal herbs and supplements, and memory-enhancing herbs and supplements.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.